Diagnosis of Alzheimer's Disease - Neuropsychological Testing

Rudolph C. Hatfield, PhD., edited by Kathryn Patricelli, MA

In addition to the psychological/psychiatric evaluation described previously, neuropsychological testing may be conducted. This can help determine more specifically the type and level of cognitive impairment that people are exhibiting. It can also identify their strengths and preserved abilities (abilities that are still functioning correctly). Information about preserved abilities is important to help form a treatment plan and recommendations about environmental modifications that would be useful. This might include job modifications, looking for a more supportive living environment, etc.

Neuropsychologists administer tests that have been developed through rigorous research to study people's:

intellectual functioning

memory capacity (short- and long-term memory)

attention

concentration

reasoning

visual spatial abilities

their ability to solve problems and learn new information.

Tests results are compared to the performance of other people of the same age and education level to determine whether a specific person is impaired. In some cases, the results of the tests can be compared to previous test results from the same person to determine if that person has experienced a decline in their cognition.

A variety of tests are available that can narrow the range of possible diagnoses by identifying patterns that indicate Alzheimer's, a head injury, stroke, or other condition. For example, someone with a head injury may exhibit amnesia as their most prominent symptom. Amnesia is an inability to learn and recall new information and/or problems remembering previously learned information or past events. Someone with Alzheimer's might show short-term memory impairment, but not necessarily amnesia.

A neuropsychologist might administer one test or a whole battery (group) of them, depending on the person. There are many combinations of cognitive tests that can be used in the diagnosis of dementia. Some of these tests are combined in standard types of test batteries. In other cases, neuropsychologists may combine different tests from different groups to make a diagnosis. The majority of neuropsychologists do not use ready-made batteries (test groupings) exclusively. Instead, they often combine some of these groupings with other tests such as IQ tests, memory scales, and other formalized approaches.

Obviously, diagnosing Alzheimer's is a complex process because the doctor (or team of health care professionals) has a great deal of information to sort through. The results of a neuropsychological test battery represent only one piece of the puzzle. Even though these test results are often a major component of an overall examination for dementia, the results of these tests are not the only findings used to diagnose dementia. If a diagnosis of Alzheimer's is made, the next step is to then begin treating the disease and symptoms.

As previously explained, there is no cure for Alzheimer's disease. However, there are some treatments and approaches that can sometimes improve symptoms and/or quality of life. The first stage of treatment is typically to address the person's cognitive symptoms with one or more the medications described in the next section. Although these drugs can be helpful, they cannot stop or reverse the disease, and eventually the disease (and symptoms) will progress. The second stage of treatment is to address the person's environment or surroundings to maximize the person's functioning. Methods for shaping the environment to be "Alzheimer's disease friendly" will also be described.